House Committee Reform Bill Slashes at Least $44 Billion in SNF Medicare Payments

VHCA (7/17/2009)

This week, HR 3200, America's Affordable Health Choices Act of 2009, was introduced in the US House of Representatives. The bill contains detrimental cuts to Medicare payments for Skilled Nursing Facilities which amount to at least $44.9 billion in cuts for Medicare Payments to SNFs alone – over ten years.  This staggering number doesn't account for the $16 billion in regulatory cuts being proposed by the Centers for Medicare and Medicaid Services (CMS) by August 1st.

The House bill contains a number of provisions that would negatively impact long term care. These cuts are contained in various provisions of the 1,018-page bill. The following lists the provisions that will likely have the greatest impact on nursing facilities:

• Section 1101 calls for a freeze in the SNF market basket update for FY 2010, beginning on January 1, 2010 – effectively taking 75% of next year’s update. 
• Section 1103 seeks to apply a “productivity” adjustment that would further downwardly adjust the SNF market basket. 
• Section 1111 would codify the recalibration of SNF payments as has been outlined by the SNF PPS proposed rule that CMS seeks to finalize by August 1. In addition, this section would alter payments for non-therapy ancillary services (NTAS) and therapy services. While these changes are considered budget-neutral and therefore are not quantified as a “cut” per se, these changes could have a meaningful impact at the facility level. 
• Section 1151, which seeks to reduce preventable hospital readmissions, would levy a less than 1% cut across providers. Although this cut pales in comparison to the market basket, AHCA is very concerned that such a policy could create perverse incentives that could negatively impact patient care. 
• Subtitle B of the bill deals entirely with nursing home transparency and includes significant requirements, most of which are outlined in the Stark-Schakowsky Nursing Home Transparency Act of 2008 (H.R. 7128). 

On a more positive note, Section 1231 of the bill extends the Medicare Part B therapy caps exceptions process through December 31, 2011.

The moment to take action is now. AHCA and VHCA ask that you contact your U.S. Representative and let him know that cuts of this magnitude are simply unsustainable. Tell your Representative that cuts to Medicare will have a negative impact on nursing homes and will create a ripple effect - putting at risk the quality of care to the frail, elderly and disabled and the loss of tens of thousands of jobs for long term care providers across the country.

We must all work to reduce or eliminate these egregious cuts before it's too late. Congress has made health care reform a priority this year and intends to pass a bill as early as August.

Your voice needs to be heard on this vital issue. You can take action today by sending a letter to your U.S. House Representative and tell them to OPPOSE Medicare payment cuts to SNFs contained within HR 3200, America's Affordable Health Choices Act of 2009.

Please click Take Action! Tab to send a letter now!